Why does this lane only treat already-diagnosed migraine?
Headache is the classic 'usually benign, occasionally catastrophic' complaint — bleeding around the brain, meningitis, inflamed arteries, masses, and pressure problems can all masquerade as a bad headache, and separating them requires a neurologic exam and sometimes imaging that no online service can do. So this lane never diagnoses: it continues treatment that an in-person clinician already established, re-verifies the safety screen at every fill, and refers out the moment anything is new or different.
Why is the supply capped at 9 doses a month?
Using a triptan on more than 10 days a month — or simple pain relievers on 15 or more days — causes medication-overuse headache, a vicious cycle where the treatment itself makes headaches more frequent. The 9-dose cap keeps you below that threshold by design, and it is never raised on request. If 9 doses is not enough, that is the signal you need preventive (daily) medication, and the physician will point you to that path instead.
Why do you ask so much about my heart and blood pressure?
Triptans work partly by narrowing blood vessels, so their FDA label contraindicates them with coronary artery disease, coronary vasospasm, stroke or TIA history, peripheral vascular disease, and uncontrolled high blood pressure. That is why the screen asks about heart history and risk factors, and why a verified blood-pressure reading below 140/90 from the last 12 months is required before any triptan — and re-attested at every refill.
What is hemiplegic or basilar migraine, and why is it excluded?
Hemiplegic migraine causes one-sided weakness with attacks, and brainstem-aura (basilar) migraine causes vertigo, double vision, or trouble speaking. Both are absolute label contraindications to every triptan, and their attacks can be indistinguishable from a stroke without emergency evaluation. If your aura has ever included weakness, speech trouble, vertigo, or double vision, this lane refers you to neurology instead of prescribing.
Can I get preventive (daily) migraine medication here?
No, and that's intentional. Guidelines say preventive treatment should be offered once you have four or more migraine days a month or attacks that impair your life despite acute treatment, and this lane asks exactly those questions. But preventives need baseline vitals, titration, and follow-up that async care cannot verify at launch, so patients who cross the threshold get structured preventive counseling and a referral to their PCP or a neurologist — including because prevention is what protects you from medication-overuse headache.
What happens at refills, and is anything automatic?
Nothing is automatic. Every fill requires a short secure-message check-in that re-asks your attack frequency, headache days per month, acute-medication days per month, any new warning signs, any new heart events, diagnoses, or medications, a blood-pressure recheck, and pregnancy status. Rising frequency triggers the preventive conversation rather than a bigger fill, and a full re-evaluation — including updated blood-pressure evidence — is required at least every 12 months.